Organization
TINY TOOTH PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SU KIM DDS (PEDIATRIC DENTIST)
(443) 812-8027
Entity
Organization
Contact information
Practice address
8808 CENTRE PARK DR STE 303, COLUMBIA, MD 21045-2224
(443) 812-8027
Mailing address
8032 TROTTERS CHASE, ELLICOTT CITY, MD 21043-7592
(443) 812-8027
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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